Black, Amy C

Black, Amy C is an individual health care provider with primary practice located at 1510 Division St Suite 200, Oregon City OR 97045-1581. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Black, Amy C can be contacted via phone (503) 650-6880.

Contact Information

Primary practice address
1510 Division St Suite 200 Oregon City OR 97045-1581
Phone: (503) 650-6880
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1031913 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA163381 Oregon

Profile Details

NPI number 1871791699
LBN Legal business name Black, Amy C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2007
Last updated Jan 13th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871791699 NPPES
Oregon MEDICAID 500663461

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